Pennsylvania, Indiana issue tentative "no, thanks" to Medicaid expansion

The Obama administration has made it abundantly clear that it would really just be oh so very helpful if all of the states would voluntarily comply with their proffered Medicaid expansion deal; ObamaCare really needs everybody to cooperate in order to work properly, so it’s really most unfortunate for them that the Supreme Court ruled last June that states were within their rights to decline the expansions without the threat of the total loss of federal Medicaid funding being held over their heads.

It was something of a boon to the Obama administration when Republican governors John Kasich in Ohio and Rick Snyder in Michigan announced that they were giving in and signing up for the Obama administration’s earlier this week, bringing the total number of GOP-led states participating to six, but other governors are still resisting the power of the all-engulfing big-government dark side. Gov. Corbett in Pennsylvania served the administration with his disinclination on Tuesday:

Pennsylvania is taking a pass on a major expansion to its Medicaid program, at least for now.

Republican Gov. Tom Corbett, in a letter sent Tuesday to U.S. Department of Health & Human Services Secretary Kathleen Sebelius, said “the Medicaid program in Pennsylvania is on an unsustainable path … I firmly believe we can serve more of our citizens in Pennsylvania, but only if we are given the independence and flexibility to do so.” …

“At this time, without serious reforms, it would be financially unsustainable for Pennsylvania taxpayers, and I cannot recommend a dramatic Medicaid expansion,” said the letter, released as part of the governor’s budget address.

And in Indiana, Gov. Mike Pence protested that he won’t be participating without more state-administered flexibility on how to run the program:

Gov. Mike Pence said Wednesday that he has ruled out expanding Medicaid under the federal health care law unless Indiana gets approval to use state health savings accounts for the expansion.

Pence told reporters that the only way he would approve a Medicaid expansion would be if the state is given the choice of using its Healthy Indiana plan to cover new enrollees.

“It was important to me that we do fully fund Medicaid, but we did not fund a Medicaid expansion, nor do I think that under the current framework for Medicaid that it would be advisable for Indiana to do that,” he said.

So, not exactly the most resounding refusals, and the remaining undecided governors still have politically tough decisions to make — Chris Christie, for instance, has to balance his presidential ambitions with his blue state’s politics. The demographics of Florida, which went for Obama, might mean that Gov. Rick Scott will eventually concede, and what’s looking like a close election battle in the Virginia gubernatorial will probably shape Gov. McDonnell’s decision. The resistance is still there, but it’s made difficult by the fact that, if one states refuses the new Medicaid funding, those state residents’ federal tax dollars are still going to funding Medicaid expansions in other states that do say yes — but the Obama administration knows that, of course. It’s all part of the plan.